慢性阻塞性肺疾病患者戒烟的新工具—一项尝试戒烟问卷的观察性纵向研究
2016/06/20
摘要
尝试戒烟问卷（TTQ），是用来测量慢性阻塞性肺病患者中充满压力的精神状态、使用破坏性的减压策略和戒烟的矛盾思想的。本研究旨在评估尝试戒烟问卷（TTQ）（有扩展版和缩减版）是否可以用来预测慢性阻塞性肺病的吸烟患者的戒烟结果。由于TTQ得分较高表明心理困扰程度较高，我们假设在TTQ基线的分数与会尝试戒烟的概率、减少吸烟的强度、以及在3个月内实现完全戒烟呈负相关。慢性阻塞性肺病的吸烟者是在有计划或无计划拜访初级保健中心后招募的，109例完成了TTQ在基线的调查，85%参加了3个月后的随访。逻辑回归分析用来衡量原始版的（19项）和缩减版（14项）的TTQ评分及三项结果之间的关系：至少做出过一次戒烟尝试、减少吸烟的强度、实现完全禁烟。在对所有参与者原始版本问卷调查进行初步分析时发现，更高的总评分与较低概率的戒烟尝试相关。根据对戒烟做准备的不同程度将患者进行分类，在对亚组进行二次分析时发现，TTQ基线分数较高与不准备戒烟的患者中完全戒烟的低概率相关（调整后的比值比(OR)=0.72；95%可信区间(CI)=0.53-0.99）。准备戒烟的患者中，心理高压患者的高评分与尝试戒烟的低概率有关（OR=0.78；95% CI =0.66-0.94），但与减少吸烟次数的高概率相关（OR=1.32；95% CI=1.05-1.66）。矛盾的想法与所有结果的低可能性有关，但评估结果均不具有统计学上的显著性。破坏性的应对策略与结果不相关。原始版本的尝试戒烟问卷（TTQ）和它的两个分量表可在预期的方向上预测戒烟效果。因此，这个问卷工具在慢性阻塞性肺病吸烟患者中裁定戒烟咨询是有用的。
（苏欣 审校）
NPJ Prim Care Respir Med. 2016 Apr 14;26:16013. doi: 10.1038/npjpcrm.2016.13.
A new instrument to predict smoking cessation among patients with chronic obstructive pulmonary disease: an observational longitudinal study of the Trying To Quit smoking questionnaire.
Lundh L1, Alinaghizadeh H1, Törnkvist L1, Gilljam H2, Galanti MR2.
Author information
Abstract
The Trying To Quit smoking questionnaire (TTQ), was developed to measure pressure-filled mental states, use of destructive pressure-relief strategies and ambivalent thoughts about quitting smoking among patients with COPD. The aim of this study was to evaluate whether the TTQ (available in an extended and in a reduced version) can be used to predict smoking cessation outcomes in smokers with COPD. As higher TTQ scores indicate higher degree of psychological distress, we hypothesised that TTQ scores at baseline would be negatively correlated with the probability of making a quit attempt, reducing the intensity of smoking and achieving complete abstinence during the 3 months. Smokers with COPD were recruited during planned or unplanned visits to primary healthcare centres, and 109 completed the TTQ at baseline and 85% participated in the follow-up after 3 months. Logistic regression was used to measure the association between the original (19 items) and the brief (14 item) version of TTQ scores and three outcomes: making at least one quit attempt, reducing the intensity of smoking and achieving complete abstinence. In a primary analysis among all the participants higher total score in the original version of TTQ was significantly associated with a lower probability of quit attempts. In a secondary analysis of subgroups of patients classified according to their readiness to quit, high TTQ scores at baseline were associated with lower probability of complete abstinence among patients not ready to quit (adjusted odds ratio (OR)=0.72; 95% confidence interval (CI)=0.53-0.99). Among patients ready to quit, high score on pressure-filled mental states was associated with lower probability of quit attempts (OR=0.78; 95% CI=0.66-0.94) but with higher probability of reduced smoking (OR=1.32; 95% CI=1.05-1.66). Ambivalent thoughts were associated with lower probability of all outcomes, but estimates were not statistically significant. Destructive coping strategies were inconsistently associated with the outcomes. TTQ in its original version and two of its subscales predicted smoking cessation outcomes in the anticipated direction. Therefore, this instrument may be useful in tailoring smoking cessation counselling for patients with COPD.
NPJ Prim Care Respir Med. 2016 Apr 14;26:16013. doi: 10.1038/npjpcrm.2016.13.
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心脏病患者戒烟：行动计划、应对计划和自我效能对戒烟的影响
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外科医生和病人对术前戒烟的行为、认识和态度
